Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study.
<h4>Background</h4>Heart Failure (HF) is the most common cause of death in Friedreich's ataxia (FRDA), an inherited mitochondrial disease. Myocardial fibrosis and myocardial hypertrophy are well-documented autopsy features among FRDA patients with HF.<h4>Objectives</h4>T...
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doaj-c65550b754e64eaaa64740d248842e5e2021-04-09T04:30:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024663310.1371/journal.pone.0246633Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study.Karen A G TakazakiThiago QuinagliaThiago D VenancioAlberto R M MartinezRavi V ShahTomas G NeilanMichael Jerosch-HeroldOtávio R Coelho-FilhoMarcondes C França<h4>Background</h4>Heart Failure (HF) is the most common cause of death in Friedreich's ataxia (FRDA), an inherited mitochondrial disease. Myocardial fibrosis and myocardial hypertrophy are well-documented autopsy features among FRDA patients with HF.<h4>Objectives</h4>To leverage the unique tissue characterization features of cardiac magnetic resonance (CMR) for characterizing myocardial remodeling in patients with genetically confirmed FRDA without HF and preserved left ventricular ejection fraction (LVEF > 55%).<h4>Methods</h4>Twenty-seven FRDA's patients (age 27.6 ± 9.7 years, 15 women) and 10 healthy controls (32.6±7.3 years, 5 women) underwent a CMR for assessment of LV function, myocardial T1, late gadolinium enhancement (LGE), extracellular volume fraction (ECV), and intracellular water-lifetime (τic), a marker of cardiomyocyte size.<h4>Results</h4>As compared to controls, FRDA patients had a preserved LVEF (LVEF: 70.5±7.4% vs. 63.9±9.0%, P<0.058), larger LV mass index (LVMASSi: 61±21.7 vs. 45±4.2g/m2, P<0.02), and decreased LV end-diastolic volume index (LVEDVi 53.1±12.0 vs. 75.7±16.1ml/m2, P<0.001), compared with controls. Additionally, ECV and cardiomyocyte size (τic,) were larger in FRDA patients (ECV: 0.36 ±0.05 vs. 0.25±0.02, P<0.001; τic: 0.15±0.08 vs. 0.06±0.03 s, P = 0.02). ECV and τic were positively associated with LV mass-to-volume ratio (ECV: r = 0.57, P = 0.003; τic: r = 0.39; P = 0.05). LVMASSi and cardiomyocyte mass-index [(1-ECV)·LVMASSi] declined with age at the CMR exam, independent of the age at initial diagnosis.<h4>Conclusions</h4>LV hypertrophy and concentric LV remodeling in FRDA are associated at the tissue level with an expansion of the ECV and an increase in cardiomyocyte size. The adverse tissue remodeling assessed by ECV and τic is associated with more severe cardiomyopathy classification, suggesting a role for these markers in tracking disease progression.https://doi.org/10.1371/journal.pone.0246633 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Karen A G Takazaki Thiago Quinaglia Thiago D Venancio Alberto R M Martinez Ravi V Shah Tomas G Neilan Michael Jerosch-Herold Otávio R Coelho-Filho Marcondes C França |
spellingShingle |
Karen A G Takazaki Thiago Quinaglia Thiago D Venancio Alberto R M Martinez Ravi V Shah Tomas G Neilan Michael Jerosch-Herold Otávio R Coelho-Filho Marcondes C França Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study. PLoS ONE |
author_facet |
Karen A G Takazaki Thiago Quinaglia Thiago D Venancio Alberto R M Martinez Ravi V Shah Tomas G Neilan Michael Jerosch-Herold Otávio R Coelho-Filho Marcondes C França |
author_sort |
Karen A G Takazaki |
title |
Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study. |
title_short |
Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study. |
title_full |
Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study. |
title_fullStr |
Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study. |
title_full_unstemmed |
Pre-clinical left ventricular myocardial remodeling in patients with Friedreich's ataxia: A cardiac MRI study. |
title_sort |
pre-clinical left ventricular myocardial remodeling in patients with friedreich's ataxia: a cardiac mri study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
description |
<h4>Background</h4>Heart Failure (HF) is the most common cause of death in Friedreich's ataxia (FRDA), an inherited mitochondrial disease. Myocardial fibrosis and myocardial hypertrophy are well-documented autopsy features among FRDA patients with HF.<h4>Objectives</h4>To leverage the unique tissue characterization features of cardiac magnetic resonance (CMR) for characterizing myocardial remodeling in patients with genetically confirmed FRDA without HF and preserved left ventricular ejection fraction (LVEF > 55%).<h4>Methods</h4>Twenty-seven FRDA's patients (age 27.6 ± 9.7 years, 15 women) and 10 healthy controls (32.6±7.3 years, 5 women) underwent a CMR for assessment of LV function, myocardial T1, late gadolinium enhancement (LGE), extracellular volume fraction (ECV), and intracellular water-lifetime (τic), a marker of cardiomyocyte size.<h4>Results</h4>As compared to controls, FRDA patients had a preserved LVEF (LVEF: 70.5±7.4% vs. 63.9±9.0%, P<0.058), larger LV mass index (LVMASSi: 61±21.7 vs. 45±4.2g/m2, P<0.02), and decreased LV end-diastolic volume index (LVEDVi 53.1±12.0 vs. 75.7±16.1ml/m2, P<0.001), compared with controls. Additionally, ECV and cardiomyocyte size (τic,) were larger in FRDA patients (ECV: 0.36 ±0.05 vs. 0.25±0.02, P<0.001; τic: 0.15±0.08 vs. 0.06±0.03 s, P = 0.02). ECV and τic were positively associated with LV mass-to-volume ratio (ECV: r = 0.57, P = 0.003; τic: r = 0.39; P = 0.05). LVMASSi and cardiomyocyte mass-index [(1-ECV)·LVMASSi] declined with age at the CMR exam, independent of the age at initial diagnosis.<h4>Conclusions</h4>LV hypertrophy and concentric LV remodeling in FRDA are associated at the tissue level with an expansion of the ECV and an increase in cardiomyocyte size. The adverse tissue remodeling assessed by ECV and τic is associated with more severe cardiomyopathy classification, suggesting a role for these markers in tracking disease progression. |
url |
https://doi.org/10.1371/journal.pone.0246633 |
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